Normalisation of mental health problems: Adolescents’ views on mental health problems and stigma

Abstract Background It is essential to listen to adolescents’ views on mental health issues since these problems are common among young people. Exposure to stigmatization is an additional burden, causing increased suffering. This qualitative descriptive study aimed to explore adolescents’ views on the prevalence of mental health problems and public stigma related to mental health problems. Methods Semi-structured individual interviews and focus group interviews were conducted with a total of 32 adolescents, aged 15-18 years. The interviews were held on Gotland, Sweden's largest island, between October and December 2020. Systematic text condensation was used to analyse the data. Results Three themes were identified: Having mental health problems is the new normal; What others think of us affects us a lot; If others lack experience and knowledge, they don't respond in a good way. The adolescents perceived mental health problems as a common phenomenon. Increased mental health problems in young people were linked to pressure related to school performance, social media and improved openness about mental health problems. Stereotypic gender norms, rumours and prejudice were perceived as important causal risk factors of mental health problems. Lack of knowledge was suggested as a source of prejudice against people suffering from mental health problems. Conclusions The adolescents recognised mental health problems as an increasing public health issue, but also as a normal phenomenon due to current living conditions for young people.. They perceived stereotypic gender norms, taboo and prejudice against mental health problems as factors contributing to and increasing mental health problems and wished for a society without such factors. The results suggest that the tri-folded description of stigma involving stereotypes, prejudice and discrimination can be applicable to adolescents. Key messages The results suggest that adolescents recognise mental health problems as an increasing public health issue but also as a normal phenomenon due to current living conditions for young people. Increased knowledge of mental health problems alongside reduction of prejudice and stereotypic gender norms was requested by the adolescents to improve young peoples’ mental health.


Background:
The association between perceived discrimination and mental health in adolescents has been widely documented. Aim of this contribution is to show how the relationship between mental health and perceived discrimination at school, work or job training differs depending on socio-economic or migrationrelated determinants.

Methods:
The present analyses was conducted with data from German Health Interview and Examination Survey for Children and Adolescents (KiGGS) wave 2 (2014 -2017). Weighted linear regression analyses were conducted to explore the association between perceived discrimination at school, work or job training and behavioral problems in adolescents (14-17 years). Also, we examined the extent to which the association is moderated by the parents' income, education as well as the language spoken at home.

Conclusions:
A large proportion of adolescents experienced discrimination, with this being reported more frequently among young people with behavioral problems. Parents' income and education as well as the language spoken at home are relevant for this context. To ensure that health inequalities are not exacerbated by discrimination, targeted prevention measures are needed in these settings. These should address not only the individual needs of young people, but also the underlying conditions and thus aim to promote health equity in the long term, especially in already disadvantaged groups.

Key messages:
Perceived discrimination is important when considering mental health, whereby these associations may vary between socioeconomic and migration-related determinants. Prevention programs regarding discrimination are needed, which address individual needs and underlying conditions of adolescents, especially in already disadvantaged groups.

Background:
It is essential to listen to adolescents' views on mental health issues since these problems are common among young people. Exposure to stigmatization is an additional burden, causing increased suffering. This qualitative descriptive study aimed to explore adolescents' views on the prevalence of mental health problems and public stigma related to mental health problems.

Methods:
Semi-structured individual interviews and focus group interviews were conducted with a total of 32 adolescents, aged 15-18 years. The interviews were held on Gotland, Sweden's largest island, between October and December 2020. Systematic text condensation was used to analyse the data.

Results:
Three themes were identified: Having mental health problems is the new normal; What others think of us affects us a lot; If others lack experience and knowledge, they don't respond in a good way. The adolescents perceived mental health problems as a common phenomenon. Increased mental health problems in young people were linked to pressure related to school performance, social media and improved openness about mental health problems. Stereotypic gender norms, rumours and prejudice were perceived as important causal risk factors of mental health problems. Lack of knowledge was suggested as a source of prejudice against people suffering from mental health problems.

Conclusions:
The adolescents recognised mental health problems as an increasing public health issue, but also as a normal phenomenon due to current living conditions for young people.. They perceived stereotypic gender norms, taboo and prejudice against mental health problems as factors contributing to and increasing mental health problems and wished for a society without such factors. The results suggest that the trifolded description of stigma involving stereotypes, prejudice and discrimination can be applicable to adolescents.

Key messages:
The results suggest that adolescents recognise mental health problems as an increasing public health issue but also as a normal phenomenon due to current living conditions for young people. Increased knowledge of mental health problems alongside reduction of prejudice and stereotypic gender norms was requested by the adolescents to improve young peoples' mental health.

Background:
Parental burnout (PB) is a relatively new syndrome resulting from chronic parenting stress. Besides efforts to enhance scientific and public understanding of PB, little is known about its link to intimate partner violence (IPV), and the psychometrics of German measures for PB remain an underresearched topic. This study aims to address these gaps by 1) testing the interplay of PB, parenting, couple satisfaction, and IPV, 2) examining the psychometrics of the German version of the Parental Burnout Assessment (PBA).

Methods:
Data were collected online as part of an international PB study including Austrian parents aged 18 or older with at least one child at home (0-18). Overall, N = 121 mothers from a community sample reported on family functioning, PB, couple quality and gender roles. Structural equation modeling was applied to assess the fit of the theoretical model. Furthermore, data from N = 220 Austrian and German parents on PB and familial variables during the Covid-19 pandemic were collected to analyze the psychometrics of the German PBA. Confirmatory factor analyses were performed to test the validity of the PBA.

Conclusions:
This study provides preliminary evidence for the importance of couples' relationship satisfaction in understanding links between IPV and PB as well as parenting in German-speaking mothers. On the basis of these findings, future public health efforts may be organized to focus on preventing PB indirectly or directly by targeting couples' relationship. Additionally, psychometric results of this study can inform researchers and practitioners about the applicability of the German PBA, improving screening of at-risk parents, and offering support for parents at early stages.